Characteristics and Fate of Orthodontic Articles Submitted for Publication: An exploratory study of the American Journal of Orthodontics and Dentofacial Orthopedics

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<bold>Purpose:</bold> The orthodontic literature lacks any study that investigates the characteristics and fate of manuscripts submitted to a top journal, such as the <italic>American Journal of Orthodontics and Dentofacial Orthopedics</italic> (AJO-DO). Having such information could be valuable to authors and editors alike in understanding critical aspects of the review process. <bold>Methods:</bold> This exploratory study looked at original articles submitted to the AJO-DO in 2008 and gathered the following information: (1) For rejected articles: main reason for rejection, publication elsewhere, and journal of subsequent publication where applicable; (2) For accepted articles: number/type of revisions and time elapsed to publication; (3) For all articles: study topic, study design, area of origin, and presence of statistically significant findings. Descriptive statistics were used to describe the manuscripts in terms of the above characteristics. Interactions between the above characteristics and rejection/acceptance/publication elsewhere were explored and reported using the Chi-squared test for equality of proportions, with Fisher's exact test used for samples of five and below. Post-hoc pairwise tests were checked against the Bonferroni correction to account for multiple testing. <bold>Results:</bold> Of the 440 original articles submitted to the AJO-DO in 2008, 113 (25.9%) were accepted for publication while 323 (74.1%) were rejected. All accepted articles underwent either major or minor revision before acceptance and were published in an average of 20.9 months (sd=4.9) after acceptance. Of the rejected articles, 137 were subsequently published in 58 different journals with an average time to publication of 22.2 months (sd=10.9) after rejection from AJO-DO. Among articles not accepted by AJO-DO, the top three reasons for rejection were: (1) Poor study design/small sample size (59% of rejected papers); (2) Outdated/Unoriginal topic (41.5%); and (3) Inappropriate for AJO-DO audience (27.2%). Manuscripts rejected for poor study design had the least success in subsequent publication, while those rejected as inappropriate for the AJO-DO had the highest rate of publication elsewhere. Neither study topic nor study design were significantly associated with acceptance to AJO-DO or publication elsewhere except among rejected observational studies, where it was found that cross-sectional studies were most likely to be published elsewhere, and case series had the least success (p=0.002). Area of origin was found to be significantly associated with acceptance to AJO-DO, with articles from USA and Canada most likely to be accepted (p<5x109). An inverse relationship was seen for publication of rejected articles in other journals, where countries with the least publishing success with AJO-DO had the highest rate of publication elsewhere. The presence of statistically significant findings was shown to be significantly associated with acceptance to AJO-DO (p=0.013) but not with publication elsewhere (p=0.77). <bold>Conclusions:</bold> Rejection by AJO-DO does not preclude publication elsewhere. Geographic origin is a predictor of acceptance to AJO-DO as well as subsequent journals. Authors aiming to maximize their chance of article acceptance should submit to an appropriate journal, use a well-designed and described study with adequate sample sizes, and emphasize the novelty and relevance of their work.